Failed angioembolization of a ruptured liver hemangioma complicated by iatrogenic injury of subclavian vein during catheter insertion [Ulus Travma Acil Cerrahi Derg]
Ulus Travma Acil Cerrahi Derg. Ahead of Print: UTD-04343 | DOI: 10.14744/tjtes.2019.04343  

Failed angioembolization of a ruptured liver hemangioma complicated by iatrogenic injury of subclavian vein during catheter insertion

Wu Seong Kang1, Young Goun Jo2, Yun Chul Park2
1Department of Trauma Surgery, Wonkwang University Hospital, Iksan, Korea
2Division of Trauma Surgery, Department of Surgery, Chonnam National University Hospital and Medical School, Gwangju, Korea

We report a case of failed angioembolization of a ruptured liver hemangioma complicated by iatrogenic injury of the subclavian vein during catheter insertion. A 30-year-old woman experienced blunt trauma upon falling from her bed. Laceration of a seemingly preexisting hepatic hemangioma was diagnosed. No other injury was detected during a preoperative diagnostic workup. Subclavian vein catheterization was performed followed by angioembolization to control bleeding due to the ruptured hemangioma. After angioembolization, the patient’s systolic blood pressure and hemoglobin level were 70 mmHg and 5.3 g/dL, respectively. She underwent emergency laparotomy. During the surgery, a large volume of blood in the abdominal cavity due to profuse bleeding from the ruptured hemangioma was observed. Because of a hemothorax found on chest radiography, we performed thoracoscopy, which revealed a large volume of blood in the right thoracic cavity and perforation of the subclavian vein by the catheter. After the damage-control surgery, the patient recovered safely. In this case, ruptured liver hemangioma complicated by subclavian vein catheter-related injury was treated safely using damage-control surgery. The catheter-related injury could be identified and treated using thoracoscopy.

Keywords: liver, injuries, hemorrhage, subclavian, catheter




Corresponding Author: Young Goun Jo, South Korea


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